According to the Mayo Clinic, approximately 10-15% of American couples experience infertility issues, defined as having frequent unprotected sex for at least a year that does not result in pregnancy. About one-third of infertility cases are due to an issue with the man, about one-third are due to an issue with the woman, and the final third are either issues with both partners or no cause can be determined. Most couples eventually conceive, with or without treatment, but some cases may need the help of a reproductive endocrinologist.
There are many potential causes of infertility that may need assessment by a professional. There are certain risk factors that can potentially increase the possibility of experiencing infertility problems. Getting these factors in check before trying to conceive can improve the odds of a successful pregnancy.
Tobacco and Marijuana Use
Smoking tobacco or marijuana can increase the likelihood of experiencing fertility issues as well as decreasing effectiveness of fertility treatment. Miscarriages are more common in women who smoke, and smoking may reduce sperm count and increase risk of erectile dysfunction in men.
Alcohol use can lead to infertility for women, and heavy alcohol use can lead to decreased sperm count and motility. Women are advised to avoid alcohol use altogether during conception and pregnancy.
Being overweight can impact fertility in women as well as reduce sperm count in men. Being underweight or experiencing eating disorders can also impact fertility in women. If you are considering conception, working towards establishing a healthy weight may improve your chances of conception.
Inactivity can contribute to obesity, which impacts fertility. Staying active also helps your body be in
optimal health. Regular activity can improve pregnancy symptoms and help facilitate a smoother delivery.
As we get older, our fertility declines. For women, fertility starts to decline during the mid-30’s, with a steeper decline after age 37. Men’s fertility starts to decline after the age of 40. While many couples conceive after this age, it may require medical intervention and treatment would likely start sooner in the process.
Other Medical Conditions
There are many other medical conditions that can impact fertility. History of cancer treatment can impact both male and female fertility. Women with endometriosis, Polycystic Ovarian Syndrome (PCOS), early menopause, scar tissue, ovulation problems, blocked fallopian tubes and many other conditions can experience more difficulty conceiving. Men may have low sperm count or low sperm motility, which could be impacted by many factors such as frequent exposure to heat, other medical conditions like diabetes or certain sexually transmitted infections, overexposure to damaging environmental factors and more.
When to Seek Help
Many couples choose to discuss their family planning with their providers at the onset. Your doctor
can help provide specific recommendations for optimal chances at conception.
If you and your partner have been trying to conceive unsuccessfully for a year, or for at least six months if
you’re 35 years or older, talk to your doctor about your unique situation. They may refer you to a specialist to do some additional investigation into what may be preventing pregnancy.
If you are experiencing difficulty conceiving, you are not alone. Talk with your partner about your concerns. Many couples also find it helpful to participate in online forums to connect with other parents in various stages of their journey. Seek the advice of a counselor to discuss your fears or frustrations. Most importantly, make sure you are taking care of your physical and emotional health. Continue pursuing your other passions and do your best to not allow the conception process to take over your life.
Testimonials from Families Who Encountered Fertility Issues
The Tinney Family
Jill and her husband Trey’s story with their daughter Reagan (7)
Trey and I knew when we got married back in 2004 that we wanted to have a family and to get it started ASAP! After trying on our own for two to three years, we started talking about trying some fertility meds.
Our doctor recommended Clomid which I feel is the most common recommendation. No success there. So after five years we finally went to a fertility specialist. I was quickly diagnosed with PCOS and learned what all that entailed.
During this time of uncertainty we turned to our faith and each other for support. Because we had already been married and best friends for so many years prior to this part of our journey, I feel like that helped us really lean on each other.
We knew it was in God’s hands, and if we were meant to have a child we would. We leaned into the fertility process 100% and after the first try with IVF we had success!
We can’t thank the doctors at UF Health enough for helping us make the biggest blessing in our lives, our precious daughter Reagan (7).
The Pinchouck Family
Lauren and her husband Lee’s story with their twins Luke (7) and Kate (7)
Lee and I got married in 2006 when I was 28 years old at the Fox theatre in Atlanta, GA. Just days after the wedding, we moved to Chicago for my husband’s job. Chicago was amazing, but a job working with my family brought us back to my hometown of Lake City, Florida in May of 2008.
After several years of wedded bliss, we decided to start our family, thinking it would be as easy and as fun as everyone says it would be. Sure enough, I got pregnant naturally when I was 30 years old. Unfortunately, we miscarried our child at eight weeks and were completely devastated. I felt like it was a secret that I had to keep close while I experienced the feelings of loss, shame and inadequacy of losing a child.
After trying to get pregnant again for four years, we started the process of fertility treatments for invitro fertilization. The retrieval process took a toll on my body and my doctor was able to retrieve just four embryos (one of which was viable to transfer). A fresh transfer three days after the retrieval brought more heartache as the transfer was unsuccessful. More self-doubt, sadness and anxiety ensued.
With more knowledge, optimism and courage, in 2013 we decided to give IVF another try. The retrieval process brought 13 viable embryos — we were elated! Eight high quality embryos were then frozen for three months. The doctor suggested transferring two embryos and made sure we were comfortable with the possibility of twins (especially at the age of 35). In agreement, we decided to transfer two embryos and they both implanted!
Nervous and excited, we found out we were having a boy and girl, and our greatest dreams were becoming a reality. Their arrival seven weeks early on March 26, 2014 gave us a scare, but Luke and Kate were perfect and shockingly both weighed 3 lbs. 13 ounces. Having spent two weeks in the NICU for being premature, it hasn’t slowed these blessings down in life, learning or happiness.
All the pain, loss and anxiety of infertility ultimately led us to the most amazing experience we call life with the Pinchouck family. We would not have it any other way.
The Winters Family
Kristen and her husband Eric’s story with their daughter Molly (7)
I feel the message hammered into our minds is how easy it is to conceive, especially when we reflect back on sexual education and teen pregnancy prevention messages, and for some it is. But for others, it’s almost impossible to conceive without the intervention of science and medicine, something I was unaware of and not prepared for until I experienced my own struggles with fertility.
After we were married in 2003, we stopped using protection and decided to see what happens, but after a year or two without success we actively started trying to start a family — charting temperatures, tracking cycles and ovulation testing. This went on for a year or two without success, and my gynecologist at the time felt there was nothing to indicate any concern, especially since I never thought to mention/discuss my heavy and painful menstrual cycles, they were regular and that was my norm since high school. After prescribing Clomid and no success, she referred us to an infertility specialist, who diagnosed me with endometriosis. He believed we should still be able to conceive via IUI, and after three failed IUI attempts we tried IVF. Our first IVF cycle was successful, I was pregnant, but then miscarried at nine weeks.
Since the first attempt was successful, we did not alter the protocol for the second IVF round, which was not successful. For the third IVF, we adjusted medications and timing, but again it was not successful. Feeling disheartened, I sought a second opinion at Cornell- Weil in NY, at which time they told me their protocol would not be much different, except to encourage me to have laparoscopy to address my endometriosis. I had the surgery. They discovered my endometriosis was a lot worse than anticipated based upon my described symptoms. During our fourth attempt, my husband was diagnosed with Lyme disease, resulting in having to stop mid-treatment and only restart once he had been treated. Once we completed our fourth attempt, again not successful, I went to see a counselor to try and come to terms and accept that I might not be able to have a biological child.
After a 10 year struggle with infertility due to endometriosis, three failed IUIs, four failed IVF attempts, and miscarriage, I realized I did not want to be in my 50s and look back and know I had not done everything I could. So seeking a third opinion in 2012 from the top reproductive facility in the world, I quit my job as therapist in an adolescent residential treatment facility (RTC) and moved to seek treatment in Colorado. It was through their research driven approach and complete alteration to my diet — removing all foods and substances that inflame the endometrial tissue, my life forever changed.
Under the close care of Dr. Eric Surrey, our fifth IVF attempt was a success! I would not change my journey for anything. Every heartbreak, tear shed, and medical treatment received was worth it. My husband and I were able to conceive with the assistance and intervention of modern medicine. Everyday I thank God (and modern medicine) for the greatest and most precious gift — my daughter, Molly. One we waited and prayed for, for what felt like an eternity.